ICU Nurse Looking for burnout/job advice...

[ICURN29]

Hello:

Just an overview of who I am, my experiences, my current job situation and concerns, and then hopefully some advice from all of you guys!

I have been a nurse for 7 years and have been working in my current position for the last 6 years. I currently work in a busy MICU/SICU and have taken on a lot of responsibility within this unit including change RN, Preceptor, and am often called on by colleagues for my clinical expertise.

At first I very much enjoyed my job in the ICU. The patients were challenging, the staff was close knit, I went to work with great energy to take care of the sickest patients within the unit, and more importantly I left feeling I took excellent care of my patients. I loved critical care and more important loved being a nurse.

Then about 3 years ago things started to change. Staffing issues started to spring up and the staffing norms within the unit started to change. Prior to the staffing crunch are staffing ratio was 2:1 (most common) 1:1 (2nd most common) and 3:1 (rare). Over the last 3 years my unit continues to struggle with staffing and we are more often times required to care for 3 patients each and it is now very rare to have a 1:1 patient. Also just as a side note my ICU provides advanced treatments such as post cardiac arrest cooling, High Freq Ventilation, Prone Therapy, IABP, ventriculostomy, and although not a trauma center we frequently use the level one for massive transfusion protocol for GI Bleeds. So as you can see the acuity level can be quite high at times, which is what makes the norm” of 3:1 staffing ratio concerning.

So, without mentioning any specific examples, there have been many times that I have found myself or observed my coworkers in patient care situations that are unsafe. This has left me to not only dread the thought of going to work, but it has worn me down so badly that I often regret my decision to become an RN in the first place. Often I find myself overwhelmed to provide safe and quality care to my patients, and routinely feel as if my patient care suffers directly related to the fact that I just cannot be in 3 rooms at one time. Management states they are trying to get us some help, but that HR and other roadblocks are slowing down the process.

So as of right now I know that I should look for another job but part of me feels guilty to leave the unit I once loved. I feel that I am turning my back on my coworkers and the patients in my hospital's community. Also being so invested (charge RN/Preceptor/Resource RN) I know that my ICU would have a hard time replacing me with a nurse that could take on all the roles I currently have. I keep telling myself its going to get better give it time” and that its not going to be better elsewhere” but the last few weeks I really have been feeling down professionally and it is effecting my personal and home life.

Any feedback, kind words, "i've been there before" or thoughts would be welcomed. Also Sorry for the long post, it was a LONG shift last night and I really needed to get this off my chest!

[Been there,done that, ASN, RN]

" I know that I should look for another job but part of me feels guilty to leave the unit I once loved. I feel that I am turning my back on my coworkers and the patients. "

Knock off the guilt. Guilty feelings are a waste of time and energy. It's time to move on.

You will be pleasantly surprised at what you are qualified for. It's all about YOU now.

[HouTx, BSN, MSN, EdD]

You don't owe them anything. They wouldn't think twice about terminating you if they thought you were unsafe... right? That goes both ways. With your experience, you're a very hot commodity. You shouldn't have any problem finding a better job. In the meantime, protect yourself by utilizing relevant processes (incident reports, compliance line, etc) if you feel that patient care is actually compromised or sub-standard.